Can Diabetes Medications Also Help Mental Health?

A study published in The Lancet Psychiatry looked at an important question for people living with both diabetes and mental health conditions: How do commonly used medications called GLP-1 receptor agonists affect depression, anxiety and overall mental well-being?

We already know that people with diabetes are at a higher risk of experiencing mental health challenges, including depression, anxiety and even self-harm. At the same time, GLP-1 medications, such as semaglutide and liraglutide, are increasingly used to treat both diabetes and obesity. However, until now, it hasn’t been clear whether these medications might improve mental health, worsen it or have no effect.

To better understand this, investigators studied approximately 95,000 people in Sweden who had diabetes and were already diagnosed with depression or anxiety. Most (60%) people were female, and the mean age was 50 years.

The team compared periods when individuals were taking GLP-1 medications to periods when they were not, essentially using each person as their own comparison. This approach helps reduce bias and provides a clearer picture of how the medications may impact mental health.

The findings were encouraging. Some GLP-1 medications, especially semaglutide, were linked to a lower risk of worsening mental health symptoms. Specifically, semaglutide was associated with a 44% reduced risk of worsening depression, a 38% reduced risk of anxiety and even a reduced risk of substance use disorders. During times of semaglutide use, people were 47% less likely to need hospital care and experience sickness absence due to substance use.

Liraglutide also showed benefits, particularly in lowering the risk of worsening depression, though its effects were more limited compared with semaglutide.

“An earlier study examining Swedish registers found the use of GLP-1 medications to be associated with a reduced risk of alcohol use disorder,” said study investigator Mark Taylor, M.D., a professor from Griffith University School of Medicine, Australia. “Alcohol-related problems often have downstream effects on mood and anxiety, so we expected the effect to be positive on these as well.”

Importantly, when looking at all GLP-1 medications as a group, researchers found a reduced risk of self-harm, which is a meaningful and reassuring finding for patients and clinicians alike.

Not all medications in this class showed the same results. Some, like exenatide and dulaglutide, did not appear to significantly change mental health risk. This highlights that even within the same drug class, effects can vary.

“Because this is a registry-based study, we cannot determine exactly why or how these medications affect mood symptoms, but the association was quite strong,” noted co-investigator Markku Lähteenvuo, M.D., Ph.D., the research director, docent from the University of Eastern Finland. “It is possible that, in addition to factors such as reduced alcohol consumption, weight loss-related improvements in body image or relief associated with better glycemic control in diabetes, there may also be direct neurobiological mechanisms involved — for example, through changes in the functioning of the brain’s reward system.”

For patients, the key takeaway is that certain GLP-1 medications may offer dual benefits, helping manage blood sugar and weight while also potentially supporting mental health. However, this study does not prove cause and effect, and more research, especially randomized clinical trials, is needed to confirm these findings.